Active NPI
Irma F Bustamante
- Addiction (Substance Use Disorder) Counselor
- Pacoima, CA
National Provider Identifier
1114457983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 11643 Glenoaks Blvd.
Pacoima, CA 91331 - Phone
- (818) 897-2609
- Fax
- (818) 890-7159
- NPI assigned
- Jun 14, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
11643 Glenoaks Blvd.
Pacoima, CA 91331
Mailing address
4760 S. Sepulveda Blvd.
Culver City, CA 90230
Phone (310) 390-6612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Didi Hirsch Psychiatric Service | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Substance Abuse Rehabilitation Facility
- Pacoima, CA
- NPI 1740539980
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497398400000",
"number": "1114457983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4760 S. SEPULVEDA BLVD.",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "90230",
"telephone_number": "310-390-6612",
"fax_number": "310-398-5690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11643 GLENOAKS BLVD.",
"city": "PACOIMA",
"state": "CA",
"postal_code": "91331",
"telephone_number": "818-897-2609",
"fax_number": "818-890-7159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSTAMANTE",
"first_name": "IRMA",
"middle_name": "F",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-14",
"last_updated": "2017-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pacoima, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.